We have still to consider the question of the transmission of malarial fevers by the ingestion of water from malarious localities. Numerous medical authors have recorded facts which they deemed convincing as showing that malarial fevers may be contracted in this way. I have long been of the opinion that while the observed facts may, for the most part, be authentic, the inference is based upon a mistake in diagnosis [determination]. That, in truth, the fevers which can justly be ascribed to the ingestion [taking into the body] of a contaminated water supply are not true malarial fevers—i. e., they are not due to the presence of the malarial parasite in the blood. This view was sustained by me, in my work on “Malaria and Malarial Diseases,” published in 1883. The fevers supposed to have been contracted in this way are, as a rule, continued or remittent in character, and they are known under a variety of names. Thus we have “Roman fever,” “Naples fever,” “remittent fever,” “mountain fever,” “typhomalarial fever,” etc. The leading physicians and pathologists, in regions where these fevers prevail, are now convinced that they are not malarial fevers, but are simply more or less typical varieties of typhoid fever, a disease due to a specific bacillus [minute comma-shaped plant], and which is commonly contracted as a result of the ingestion of contaminated water or food. The error in diagnosis, upon which the inference has been based that malarial fevers may be contracted through drinking water, has been widespread in this country, in Europe and in the British possessions in India. It vitiated our medical statistics of the Civil War and of the recent war with Spain. In my work already referred to, I say:
“Probably one of the most common mistakes in diagnosis, made in all parts of the world where malarial and enteric [intestinal] fevers are endemic [characteristic of the locality], is that of calling an attack of fever, belonging to the last mentioned category, malarial remittent. This arises from the difficulties attending a differential diagnosis at the outset, and from the fact that having once made a diagnosis of malarial fever, the physician, even if convinced later that a mistake has been made, does not always feel willing to confess it. The case therefore appears in the mortality returns, if it prove fatal, or in the statistical reports of disease, if made by an army or navy surgeon, as at first diagnosed.”
THE ART OF PROLONGING LIFE
Robson Roose, M.D.
[Dr. Robson Roose, an eminent physician of London, is the author of standard works on Gout on Nerve Prostration, on Waste and Repair in Modern Life. The Fortnightly Review, 1889, contained the admirable article which follows: it is reprinted with the kind permission of the author and the editor.]
The doctrine that a short life is a sign of divine favour has never been accepted by the majority of mankind. Philosophers have vied with each other in depicting the evils and miseries incidental to existence, and the truth of their descriptions has often been sorrowfully admitted, but they have failed to dislodge, or even seriously diminish, that desire for long life which has been deeply implanted within the hearts of men. The question whether life be worth living has been decided by a majority far too great to admit of any doubt upon the subject, and the voices of those who would fain reply in the negative are drowned amid the chorus of assent. Longevity, indeed, has come to be regarded as one of the grand prizes of human existence, and reason has again and again suggested the inquiry whether care or skill can increase the chances of acquiring it, and can make old age, when granted, as comfortable and happy as any other stage of our existence.
From very early times the art of prolonging life, and the subject of longevity, have engaged the attention of thinkers and essayists; and some may perhaps contend that these topics, admittedly full of interest, have been thoroughly exhausted. It is true that the art in question has long been recognized and practiced, but the science upon which it really depends is of quite modern origin. New facts connected with longevity have, moreover, been collected within the last few years, and some of these I propose to examine, and further to inquire whether they teach us any fresh means whereby life may be maintained and prolonged.
But, before entering upon the immediate subject, there are several preliminary questions which demand a brief examination, and the first that suggests itself is, What is the natural duration of human life? This oft-repeated question has received many different answers; and inquiry has been stimulated by skepticism as to their truth. The late Sir George Cornewall Lewis expressed the opinion that one hundred years must be regarded as a limit which very few, if indeed any, human beings succeed in reaching, and he supported this view by several cogent reasons. He pointed out that almost all the alleged instances of abnormal longevity occurred among the humbler classes, and that it was difficult, if not impossible, to obtain any exact information as to the date of birth, and to identify the individuals with any written statements that might be forthcoming. He laid particular stress upon the fact that similar instances were altogether absent among the higher classes, with regard to whom trustworthy documentary evidence was almost always obtainable. He thought that the higher the rank the more favourable would the conditions be for the attainment of a long life. In this latter supposition, however, Sir George Lewis was probably mistaken: the comforts and luxuries appertaining to wealth and high social rank are too often counterbalanced by cares and anxieties, and by modes of living inconsistent with the maintenance of health, and therefore with the prolongation of life. In the introduction to his work on “Human Longevity,” Easton says, “It is not the rich or great ... that become old, but such as use much exercise, are exposed to the fresh air, and whose food is plain and moderate—as farmers, gardeners, fishermen, labourers, soldiers, and such men as perhaps never employed their thoughts on the means used to promote longevity.”